Equipment and consumables application training
Will ensure staff gain intensive in-depth understanding of new technology and functions of the equipment and disposables purchased, based on published research.
Competency evaluation of staff in use of equipment and disposables, with ongoing assessment and updating as clinical research dictates.
The equipment application training is best done BEFORE the hospital opens for business, and is then followed up with supervisory training when patients are admitted.
The inception training will involve both theoretical and practical hands on training, and would be done in accordance with staffing and clinical area needs.
Clinical Application training.
Phase 2 builds on phase one and will place the embedded knowledge gained in phase one into the CLINICAL situation. Staff will learn anatomy physiology and pathophysiology of clinical conditions where the equipment and consumables are used, and by combining the knowledge gained in phase one and phase two, will develop the ability and skills to safely use the equipment and disposables in the clinical areas, and optimise the use of equipment and consumables in relation to the clinical pathology of the patient.
Central lines and CVP monitoring.
The staff will gain in-depth knowledge of the actual devices and monitors, the monitoring wave forms, interpretation of the CVP wave form, how to respond to varying CVP readings, troubleshoot, and optimise patient therapy.
Clinical evidenced based teaching which will take the format of supervisory care, clinical ward rounds, guest speakers, journal clubs, and continuing education seminars.
This teaching will be GENERIC.
Mechanical ventilation is an art and a science which requires specialist knowledge of RESPIRATORY PATHOPHYSIOLOGY, rather than of the ventilator purchased. It is essential that the staff understand what the pathology is, and are then able to match this with optimising the ventilator in terms of the pathology.
Staff will be mentored and encouraged to participate in clinical research, and encouraged to present the results at congresses, and publish in journals. Research undertaken will be in conjunction with the local university.
NEW FOCUSES IN CLINICAL PRACTICE AND EDUCATION.
Integrated Care pathways are being used internationally and to a lesser extent locally, Integrated Care Pathways are evidenced based and virtually guarantees SAFE BEST PRACTICE of nurses.
Care bundles are comprised of individual evidenced based practices which when combined into a Care Bundle have been shown to significantly reduce infection rates amongst patients.
Central Line Care Bundle.
The Central Line Bundle consists of five interventions designed to prevent central venous catheterization-related blood stream infections.
- Washing hands for about 2 to 3 minutes before handing patients.
- Alternatively, use an alcohol-based, waterless hand cleaner before coming into contact with patients.
- The operator inserting the central venous catheter should wear a cap, mask, sterile gown and gloves.
- The patient should be covered with a sterile drape from head to toe, with a small opening at the site of insertion, to reduce the risk of line contamination.
Chlorhexidine skin antisepsis:
- Evidence suggests that a solution of 2 percent Chlorhexidine in 70 percent alcohol provides better antisepsis than iodine.
- Antiseptic solution should be allowed to dry completely before puncturing the insertion site.
Catheter site selection:
- A subclavian vein is the preferred site for non-tunnelled catheters.
- The jugular vein site is preferred over the femoral vein site.
- Central venous line necessity should be reviewed daily, with an aim to remove unnecessary lines.
Clinical auditing and tracking is compulsory overseas. A system of clinical auditing can be implemented and staff trained on how to enter and use the data. Nursing clinical audits can be part and parcel of the integrated care pathways.